Spring/Summer Issue 2014

by Marcia Hill Gossard ’99, ’04 Ph.D. | Photo by Henry Moore, Jr.

In a large room filled with a half dozen tables, groups of students are following what might appear to be sewing instructions with stich names such as “cruciate” and “simple interrupted.” At the top of the sheet it reads: Practice Made Perfect. For the WSU veterinary students who are actually learning basic surgical suturing skills, this kind of practice gives them the confidence they need to perform surgeries later in the program.

“Because I already knew the basic skills, I was able to focus on advanced techniques,” says Hillary Carroll, a fourth year DVM student who plans to become an equine emergency surgeon. “And because I had more advanced skills, clinicians were able to give me a more primary role instead of being purely an assistant.”

Three years ago, Dr. Julie Cary and her colleagues began offering open labs to hone surgical skills in a simulated environment to better prepare WSU veterinary students for the job market. What they found was that students felt more comfortable experimenting with different surgical techniques when they worked with other students.

“Student were more likely to try new techniques with their peers, rather than with professors,” says Cary, a clinical associate professor. So using a peer teaching model, she started training second and third year veterinary students to work as teaching assistants in the labs.

“As a teaching assistant for the lab, I can say first hand that I have watched students at WSU grow in their surgery skills in ways that students don’t have opportunities to until the third year in other programs.”
—Amy Berry (’15 DVM) from Wyoming, who is a teaching assistant in the lab. She wants to practice agricultural animal and equine medicine in rural America.

The labs were so popular that after a few years they realized that they needed their own space.

“It was important to be able to offer the labs at regular times so students could have consistent opportunities to practice,” says Cary. “The students really pushed for it.”

In September 2013, with the support of students, the college, and some generous donations, they were able to renovate several rooms in McCoy Hall, the site of the college’s original teaching hospital. The students have been instrumental in creating an environment that feels comfortable to them, says Cary. Students can ask the teaching assistants questions, and Dr. Cary is nearby if students need additional assistance.

“It is a great opportunity for students to become teachers and really master the skills,” says Micall Godderidge (’15 DVM) from Utah, who plans to work in a large animal private practice.

The peer-teaching model has helped to create a student culture where it is the norm to help one another. The peer-based format also has a low-stress, non-intimidating environment, says Godderidge.

Now officially named the Clinical Simulation Center, the goal over the next three years is to expand the center to offer more high fidelity simulation models. High fidelity models provide the physical, or haptic, feedback that a veterinarian would feel during an actual exam or surgical procedure. The center plans to add a Calgary Horse, haptic cow, and haptic horse.

“With haptic technology students can feel the different stages of pregnancy in a cow,” says Cary. “They can also see on the video screen what they are feeling. It is a much more effective way to learn.”

“Training in the lab gave me a better sense of confidence. Being able to remain confident in the face of pressure is invaluable.”
—Hillary Carroll (’14 DVM) from Montana. This summer she will start an equine internship at North Carolina State University

Renovations in phase two will also include a simulated operating room (to be completed in August 2014). The remodeled space will provide students with the opportunity to practice their skills in a more realistic setting. During critical care simulation, students will work though a problem as a team. They will practice the technical aspects of a medical issue, such as cardiac arrest, but they will also get to experience team dynamics, which can affect patient outcomes. While these types of simulations have frequently been done in human medicine, they have been less common in veterinary medicine.

“Often people turn to the senior person in the surgical room,” says Cary. “If that person is having an off day or misses something, the others in the room won’t always speak up. So we have to train them how to do that in the appropriate way.”

One of the most important benefits of this kind of training is that it helps to prevent medical errors.

“People tend to become frantic in an emergency,” says Cary. “So students need to learn how to slow down to avoid making a mistake. They learn to manage their emotions and not get tunnel vision.”

In the final phase of development, Dr. Cary hopes to construct a debriefing room for small group teaching and to discuss what may have gone wrong in the simulation and what they could do better next time.

“We are integrating clinical communication with technical procedures,” says Cary. “Students will have the opportunity to practice an entire case before they even graduate.”

The labs are currently open to WSU veterinary students, interns, and residents. In the next five years, the goal is to expand educational opportunities to veterinary staff and practitioners.

“The surgery skills lab has provided me hours of hands-on practice that I would not have gotten anywhere else,” says Amy Berry (’15 DVM), a teaching assistant in the lab. “It will be invaluable for me as I proceed in my career.”

Learn more about the WSU Clinical Simulation Center and how you can help our veterinary students.